Cervicalgia is the term used to describe pain located in the cervical spine, or what is commonly known as the neck region. It is one of the most frequent reasons for seeking medical advice for musculoskeletal pain, affecting both young people and adults. Identifying its origin and applying appropriate treatment is essential to alleviate symptoms and prevent the pain from becoming chronic.
What is cervicalgia and why does neck pain occur?
Cervicalgia is the medical term that describes pain located in the cervical spine, that is, in the neck region. It is one of the most frequent causes of musculoskeletal pain and can affect both young people and adults. Neck pain occurs when the structures in the area become inflamed or overloaded, generating tension and limiting movement.
In general, neck pain is related to sustained muscle strain, combined with prolonged poor posture or stress. Working long hours in front of a computer, using a mobile phone with your head tilted forward, or sleeping in an improper position can contribute to muscle tension and the development of persistent pain in both the neck and shoulders.
What is the difference between acute and chronic neck pain?
Acute neck pain is characterized by recent onset, less than six weeks prior, that appears after a sudden strain, a sudden movement, or an intense muscle spasm. While it significantly limits mobility, it responds well to conservative treatment and improves progressively with physical therapy and pain management.
Chronic neck pain, on the other hand, usually persists for more than three months or recurs frequently. In these cases, there is often a multifactorial component, such as muscle weakness, persistent postural abnormalities, or degenerative changes in the cervical spine. Treatment in this case requires a more structured plan to prevent relapses and reduce the chronicity of the pain.
What factors cause overload in the cervical area?
Cervical overload occurs due to maintaining prolonged postures with the head forward and shoulders hunched., This is all too common in sedentary work. Both the lack of active breaks and the absence of strengthening exercises for the neck muscles cause the spine to bear a greater load than it is prepared to tolerate.
Other factors that can cause this condition include prolonged stress, improper use of pillows or mattresses, and lack of regular exercise. When these elements combine, the cervical area becomes stiff, contracted, and painful, which can become persistent if not addressed promptly.
What symptoms does cervicalgia produce in the neck and shoulders?
The main symptom of cervicalgia is pain located in the back of the neck, which often radiates to the shoulders, the area between the shoulder blades, or the trapezius muscles. This pain is accompanied by stiffness and difficulty turning or tilting the head, especially after prolonged periods in the same position. A feeling of constant tension or palpable muscle spasm is also very common.
Neck pain can intensify after working at a computer or driving for extended periods. Another common sign is muscle fatigue in the neck area and a feeling of heaviness in the head, due to the strain on the muscles when they are overloaded.
When does neck pain cause dizziness or headaches?
In certain cases, cervicalgia can be associated with tension headache, especially when the contracture affects the upper cervical muscles, starting at the base of the skull and radiating towards the forehead or temporal area.
Some patients describe a mild feeling of instability or nonspecific dizziness, which may be related to alterations in cervical proprioception, that is, in the mechanisms that regulate balance. If the dizziness is intense, persistent, or accompanied by other neurological symptoms, a medical evaluation should be performed to rule out other causes.
What signs indicate nerve damage?
When neck pain is accompanied by tingling, numbness, or loss of strength in one of the arms, there may be irritation or nerve compression originating from the cervical nerve root. This is known as cervicobrachialgia and is usually related to herniated discs or protrusions that affect the nerve.
The presence of progressive weakness, marked loss of sensation, or even alterations in coordination require specialized assessment, as these are signs different from a simple contracture and may indicate a significant neurological impairment.
What causes the most frequent neck pain?
The most common cause of neck pain is prolonged muscle strain. Repeated muscle contractions, prolonged postures, and lack of movement create tension in the neck muscles, leading to persistent pain.
Other causes include age-related degenerative changes, such as wear and tear of intervertebral discs or osteoarthritis in the cervical facet joints, and, to a lesser extent, trauma, sudden movements, or sports injuries that can trigger acute neck pain.
How does sedentary work affect neck pain?
Sedentary work is one of the factors that most contributes to neck pain, given the bad habits it generates.
Holding your head forward and shoulders hunched for hours increases the load on the cervical spine and forces the muscles to work under constant tension. This sustained posture reduces muscle endurance, promoting the development of muscle contractures.
Not taking active breaks and not strengthening the deep cervical muscles aggravates the problem, potentially making the pain chronic and causing recurring episodes of neck pain.
What injuries or hernias can cause neck pain
Cervical disc herniations usually cause localized pain in the neck and, in more complex cases, radiate to the arm if there is nerve compression. Disc protrusions and progressive disc wear can also cause inflammation and persistent pain.
Not all alterations visible in an MRI produce these symptoms; it is key to evaluate the imaging tests with the patient's medical history, avoiding unnecessary overdiagnosis.
How to correctly diagnose cervicalgia
The diagnosis of cervicalgia is primarily clinical and is based on a detailed history of the pain, its duration, intensity, and a record of factors that worsen or relieve it. The diagnosis includes an analysis of mobility, tender points, muscle contractures, and possible signs of neurological involvement.
When the pain is recent and there are no radiating symptoms or alarm signs, it is not necessary to perform imaging tests immediately, but making at least one diagnosis avoids unnecessary studies and allows conservative treatment to begin quickly.
What medical tests help identify the cause of the pain?
When neck pain persists, recurs frequently, or is accompanied by arm symptoms, further testing is advisable. A plain X-ray assesses cervical alignment and degenerative bone changes, although it does not provide detailed images of the discs or nerve structures.
Magnetic resonance imaging (MRI) is the most comprehensive test for studying intervertebral discs, nerve roots, and the spinal cord. It allows for the identification of herniated discs, protrusions, or signs of nerve compression that may explain the patient's symptoms.
When is a cervical MRI necessary?
A cervical MRI is indicated when pain does not improve after several weeks of treatment, when pain radiates to the arm with tingling or weakness, or when neurological signs suggestive of nerve compression appear. It is also used in cases of persistent, severe pain with no clear cause.
Which treatment is most effective for neck pain
The most effective treatment for neck pain depends on the cause and duration of the pain, but in most cases the treatment is conservative. It is recommended to maintain adapted and progressive activity to promote recovery, in addition to carrying out pain control through medication prescribed by a professional, especially when there is intense contracture or marked limitation of mobility.
As recovery progresses, it's important to address the factors that cause neck strain, including improving posture, adjusting the work environment, and strengthening the neck muscles. When pain becomes chronic or is accompanied by neurological symptoms, a specialized approach and evaluation of different treatments are necessary.
What role does physiotherapy play in neck pain?
Physiotherapy is one of the most effective tools in the treatment of cervicalgia, since it allows reducing muscle contracture, improving cervical mobility and restoring the balance of the cervical muscles.
Through manual therapy, therapeutic exercise, and postural re-education, both the symptom and the cause of the problem are addressed., The aim is not only to relieve current pain, but also to improve the strength and stability of the cervical spine and prevent the problem from recurring over time.
When is specialized medical treatment recommended?
Specialized medical treatment is recommended when neck pain does not improve after several weeks of conservative management or when it recurs repeatedly, interfering with daily activity.
It is also necessary when the pain is accompanied by neurological symptoms such as tingling, loss of strength in the arm, or radiation of persistent pain in the upper limb.
In these cases, it is crucial to rule out herniated discs, nerve compression, or other structural pathologies. Treatment may include medication, injections, or an individualized rehabilitation plan based on the diagnosis.
When to see an orthopedist for persistent neck pain
It is recommended to see an orthopedist when neck pain lasts for more than several weeks without improvement, limiting work or nighttime rest, or is associated with symptoms radiating to the arm.
A specialized evaluation will be able to identify the specific cause of the neck pain and establish an individualized plan, preventing neck pain from becoming a chronic problem. Accurate diagnosis and early treatment increase the chances of a full recovery and reduce the risk of relapse.
